COVID-19’da akciğerlerde meydana gelen anatomik değişiklikler

Yıl 2025, Cilt: 35 Sayı: 6, 1102 - 1112

Dilek Şahin , Nadire Ünver Doğan , Nazlım Aktuğ Demir , Mustafa Koplay , Zeliha Fazlıoğulları , Şua Sümer , Ahmet Kağan Karabulut , Onur Ural , Esranur Kıratlı

Öz

Amaç: Çalışmamızda COVID-19 hastalarında Bilgisayarlı Tomografi (BT) görüntüleri üzerinde trachea ve bronşlarda çap ve uzunluk ölçümleri yapılarak, herhangi bir değişiklik meydana gelip gelmediğinin belirlenmesi amaçlandı.
Gereç ve Yöntemler: Çalışma, COVID-19 tanısı ile takip ve tedavi edilen 78 hasta ile 52 sağlıklı kontrol grubunda gerçekleştirildi. COVID- 19 hastalarının BT görüntüleri üzerinde trachea çapı, trachea kesit alanı, bronşların çap ve uzunlukları, pulmoner arter çap değerlerinin ölçülerek, COVID-19 hastalığı olmayan kişilerdeki ölçüm değerleriyle karşılaştırılması yapıldı.
Bulgular: COVID-19 hastalarında cinsiyete ve BT tutulum düzeyine göre trachea ve bronşların bazı morfometrik ölçümlerinde anlamlı farklılıklar saptandı. Ayrıca COVID-19 hastalarının pulmoner arter çapında anlamlı düzeyde artış görüldü.
Sonuç: Akciğer BT özelliklerinin ve pulmoner arter çapının birlikte değerlendirilmesi, risk altında olabilecek hastaları ve gelişebilecek komplikasyonları tahmin etmeye yardımcı olabilir. Ulaşabildiğimiz literatürlerde, COVID-19 hastalarında hava yollarının morfometrik açıdan değerlendirilmesine dair çalışmalara rastlayamadık. Çalışmamızda elde edilen verilerin COVID- 19 ile ilgili literatüre katkı sağlayacağını düşünmekteyiz.

Anahtar Kelimeler

COVID-19 , Bronş , Trakea , Morfometri , Bilgisayarlı tomografi

Anatomical changes in the lungs in COVID-19

Öz

Background/Aims: Our study aimed to determine whether any changes occurred in the trachea and bronchi of COVID-19 patients by making diameter and length measurements on Computed Tomography (CT) images.
Methods: The study was conducted on 78 patients diagnosed with COVID-19, followed up and treated, and 52 healthy controls. Tracheal diameter, tracheal cross-sectional area, bronchial diameter and length, and pulmonary artery diameter values were measured on CT images of COVID-19 patients and compared with the measurement values of people without COVID-19 disease.
Results: As a result of our study, significant differences were found in some morphometric measurements of the trachea and bronchi in COVID-19 patients according to gender and CT involvement level. In addition, there was observed a significant increase in pulmonary artery diameter in COVID-19 patients.
Conclusion: The combined evaluation of lung CT features and pulmonary artery diameter may help to predict patients who may be at risk and complications that may develop. In the literature we can access, we could not find any studies on the morphometric evaluation of airways in COVID-19 patients. We think that the data obtained in our study will contribute to the literature on COVID-19.

Anahtar Kelimeler

COVID-19 , Bronchus , Trachea , Morphometry , Computed tomography

Etik Beyan

Funding The authors declare that this work has not received any funding. Conflict of interest The authors of this manuscript declare that no relationships exist with any companies whose products or services may be related to the subject matter of the study. Informed consent This study is retrospective, so there was no need to receive informed consent.

Kaynakça

• 1. Mehta OP, Bhandari P, Raut A, Kacimi SEO, Huy NT. Coronavirus disease (COVID-19): comprehensive review of clinical presentation. Front Public Health. 2021;8:582932.
• 2. Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med. 2020;383(2):120-8.
• 3. Buja LM, Wolf DA, Zhao B, Akkanti B, McDonald M, Lelenwa L, et al. The emerging spectrum of cardiopulmonary pathology of the coronavirus disease 2019 (COVID-19): Report of 3 autopsies from Houston, Texas, and review of autopsy findings from other United States cities. Cardiovasc Pathol. 2020;48:107233.
• 4. Mulay A, Konda B, Garcia G, Yao C, Beil S, Villalba JM, et al. SARS-CoV-2 infection of primary human lung epithelium for COVID-19 modeling and drug discovery. Cell Rep. 2021;35(5).
• 5. Ural O, Kıratlı HE, Sümer Ş, Aktuğ Demir N, Yılmaz Kırık S, Vatansev H, et al. Evaluation of annexin-1 (ANXA-1), annexin-2 (ANXA-2) and bone morphogenetic protein-7 (BMP-7) serum levels in patients followed up with a diagnosis of COVID-19. Mikrobiyol Bul. 2022;56(1):25-35.
• 6. Olivier P, Hayon-Sonsino D, Convard JP, Laloë P-A, Fischler M. Measurement of left mainstem bronchus using multiplane CT reconstructions and relationship between patient characteristics or tracheal diameters and left bronchial diameters. Chest. 2006;130(1):101-7.
• 7. Kamel KS, Lau G, Stringer MD. In vivo and in vitro morphometry of the human trachea. Clin Anat. 2009;22(5):571-9.
• 8. KILIÇ C, KIRICI Y, OZAN H. Morphometrically Assessment of the Bronchial Tree. Turkiye Klinikleri Archives of Lung. 2009;10(2):45-50.
• 9. Horsfield K, Cumming G. Morphology of the bronchial tree in man. J Appl Physiol. 1968;24(3):373-83.
• 10. Edwards P, Bull R, Coulden R. CT measurement of main pulmonary artery diameter. The Br J Radiol. 1998;71(850):1018-20.
• 11. Esposito A, Palmisano A, Toselli M, Vignale D, Cereda A, Rancoita PMV, et al. Chest CT–derived pulmonary artery enlargement at the admission predicts overall survival in COVID-19 patients: insight from 1461 consecutive patients in Italy. Eur Radiol. 2021;31(6):4031-41.
• 12. Spagnolo P, Cozzi A, Foà RA, Spinazzola A, Monfardini L, Bnà C, et al. CT-derived pulmonary vascular metrics and clinical outcome in COVID-19 patients. Quant Imaging Med Surg. 2020;10(6):1325.
• 13. Xiong M, Liang X, Wei YD. Changes in blood coagulation in patients with severe coronavirus disease 2019 (COVID‐19): a meta‐analysis. Br J Haematol. 2020;189(6):1050.
• 14. Karabaş SA, Çiftçi R, Ulubaba HE, Yoldaş A. Investigation of subcarinal angle and tracheobronchial morphology in patients with COVID 19: a retrospective computed tomography study. Konuralp Med J. 2023;15(2):266-72.
• 15. Erkaya A, Coskun ZK, Akyol S, Peker TV, Kuçlu T, Aksakal FNB, et al. Morphometric Examination of the Trachea and Bronchi in Follow-up Computed Tomography Scans of COVID-19 Patients. Int J Morphol. 2023;41(2).